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A catastrophic complication of hip arthroscopy
Maurilio Bruno1, Valentina Longhino, Valerio Sansone
1Orthopaedic Department, Università degli Studi di Milano, Istituto Ortopedico Galeazzi IRCCS, Milan, Italy.
Summary
Hip arthroscopy can cause serious inferior gluteal artery injury, leading to anemia and nerve damage. A safe portal technique is described to prevent this rare complication.
Area of Science:
- Orthopedic Surgery
- Vascular Complications
- Hip Arthroscopy
Background:
- Hip arthroscopy is a common procedure for hip joint pathology.
- Minimally invasive techniques aim to reduce surgical risks.
- Potential complications, though rare, require careful consideration.
Observation:
- A patient developed severe anemia and a large pseudoaneurysm after hip arthroscopy.
- The pseudoaneurysm resulted from severance of the inferior gluteal artery.
- Sciatic nerve compression by the pseudoaneurysm caused permanent neurologic deficits.
Findings:
- This is the first reported case of inferior gluteal artery severance during hip arthroscopy.
- The vascular injury led to significant blood loss and secondary complications.
- Neurologic sequelae were directly attributed to the pseudoaneurysm's mass effect.
Implications:
- Highlights a critical, previously unreported risk of hip arthroscopy.
- Emphasizes the need for meticulous surgical technique and anatomical awareness.
- Proposes a modified posterior portal approach to enhance safety and prevent similar incidents.
